Dental Utilization for Medicaid-Enrolled Children With Cystic Fibrosis in Iowa

Objectives: Cystic fibrosis (CF) is the most common lethal genetic disease in Caucasians. Despite a highly cariogenic diet and frequent use of inhaled xerostomia-inducing drugs, children with CF are believed to have a lower caries prevalence than other children. Possible reasons include antibiotic or medication use, protective salivary characteristics, or increased use of health services, including preventive dental care. This study goal was to compare dental care use for Medicaid-enrolled children with and without CF.


Methods: We analyzed 2012 Iowa Medicaid data for children age 3 –17 who were enrolled in Medicaid for at least 11 months. Regression analysis was used to determine utilization rates for any dental care and also for specific categories of dental care: diagnostic, preventive, routine restorative, and complex restorative.
Results: The study included 156,268 children, of whom 85 had CF. Children with CF were significantly less likely to use any type of dental care than children without CF after adjusting for race (incident rate ratio: 0.843, 95% CI: 0.82–0.86). Among children who utilized any dental care, children with CF were more likely to have used diagnostic and preventive care and less likely to have used restorative care than children without CF, but these differences were not statistically significant.
Conclusions: Medicaid-enrolled children with CF are less likely to use dental care than non-CF children. These findings suggest that disparities in dental care use are an unlikely cause of reduced caries rates in children with CF.